Reasons for not receiving the HPV vaccine among eligible adults: Lack of knowledge and of provider recommendations contribute more than safety and insurance concerns

Abstract

Background The upward trends of vaccine exemptions in Texas are alarming. While HPV vaccine rates in this State are among the lowest nationwide, factors that contribute to the low HPV vaccination uptake among adults remain unknown. In this study, we examined the main reasons for not receiving HPV vaccination among age‐eligible adults. Methods The Texas health screening survey (2018), a multistage area probability design‐based survey of a representative sample of Texas residents, was used to identify 907 eligible adults (age ≥ 18 years) respondents, including 724 women aged ≤ 26 years in 2007 (≤38 years in 2018), and 183 men aged ≤ 21 years in 2011 (≤28 years in 2018). Participants who reported having never received an HPV shot, where asked the main reason for not receiving the vaccine. Results Overall, 58.5% (95%CI: 55.1‐62.0) of vaccine eligible adults reported having never received the HPV vaccine. The most commonly reported reasons for not receiving it were: did not know about the vaccine (18.5% (14.9‐22.1)), and provider did not recommend (14.1% (10.9‐17.4)). In contrast, commonly perceived reasons such as: safety concerns (7.2% (4.8‐9.5)), lack of insurance (3.4% (1.7‐5.1), and concerns about increasing sexual activity if vaccinated (0.2% (0.0‐0.5)), were less frequently reported. Conclusion Among vaccine‐eligible adults, safety and sexuality concerns do not appear to be the prime factors underlying low HPV vaccination rates. Rather than emphasizing them, educational interventions should aim at improving vaccine's knowledge, and enhancing provider recommendations on the necessity of HPV vaccination.

HPV Vaccination Training of Healthcare Providers and Perceived Self-Efficacy in HPV Vaccine-Hesitancy Counseling

“…Of note, the effect of formal training on the self-efficacy of HCPs in addressing HPV vaccine hesitancy, as seen in our study, was consistent for both hesitant parents and adult patients. Whereas safety concerns top the reasons for HPV vaccine hesitancy among parents of adolescents, lack of knowledge and recommendation of HPV vaccine is the main reason for HPV vaccine hesitancy in adults [32,33]. Additionally, HPV vaccine initiation rates vary among adolescents and adults, indicative of potential disparity in the rate of hesitancy by patient age [34][35][36].…”

Parents’ Acceptance of COVID-19 Compared to Human Papillomavirus Vaccines

“…Finally, previous studies have shown that healthcare provider recommendations can help improve vaccine uptake [ 35 , 36 ]. However, our results showed that for COVID-19 vaccines, news coverage about the vaccine was sufficient in providing parents with the confidence to vaccinate their children before talking to healthcare providers.…”

Health literacy and its association with human papilloma virus vaccination among adults: Findings from the behavioral risk factor surveillance system

“…12 Multiple studies have described children and adults who have received HPV vaccination compared to those who did not. Low HPV vaccination rates among different subgroups of the population have been associated with racial/ethnic minorities, 13 college or less than college maternal education, 14 not having a well-child doctor visit, 14 not seeing a health care provider in the past 12 months, 15 not having health insurance, 15 living in a lower-income household, 15 not receiving a provider recommendation for HPV vaccine, 14 , 16 and lack of enough knowledge about the vaccine. 16 …”